Background to this inspection
Updated
12 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of one inspector and an Expert-by-Experience. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Chichester Court is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and 10 relatives about their experience of the care provided. We spoke with 10 members of staff including the regional manager, the registered manager, deputy manager, one nurse, one senior support worker, four support workers and the kitchen assistant. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included six people’s care records and three medicines records. We looked at four staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
12 July 2019
About the service
Chichester Court is a residential care home providing personal and nursing care to 37 people aged 65 and over. The service can support up to 50 people.
The home was divided into two separate units, one provided general nursing care and one provided support to people who lived with dementia. Both units had separate adapted facilities.
Improvements had been made since the last inspection and people, relatives and staff were very positive about the changes introduced by the new registered manager. These included changes to the environment, staffing and person-centred care.
Without exception people and relatives told us the service was well-led and all said they would recommend it to others. One relative told us, “The new manager is excellent. Staff create a home from home and it makes a more relaxed atmosphere.”
People told us they felt safe with staff support and staff were approachable. One person told us, “The staff are brilliant.” Another said, “The staff would sort out any problems, not that we have any.” Arrangements for managing people's medicines were safe.
People and staff told us they thought there were enough staff on duty to provide safe and individual care to people. One relative said, “I can’t speak highly enough of the care here. It means I can sleep at night.”
There was a better standard of hygiene than at the last inspection. Changes were being made to the environment to promote the orientation and independence of people who lived with dementia. A relative commented, “Work has been done on the dementia unit.”
There was an improved standard of record keeping to ensure people received personalised care that met their needs. People's privacy and dignity were respected.
The atmosphere was relaxed and tranquil. A range of activities and entertainment were available to keep people interested and stimulated. One relative told us, "[Name] has started socialising more."
Staff were subject to robust recruitment checks. Communication was effective, staff and people were listened to. Staff said they felt well-supported and were aware of their responsibility to share any concerns about safeguarding and the care provided.
People were provided with good standards of care by staff who were trained and supported in their roles. We have made a recommendation about following best practice guidelines for keeping nursing staff clinical competencies up-to-date and for clinical supervision arrangements.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
There was a strong and effective governance system in place. The management team carried out a regular programme of audits to assess the safety and quality of the service. There were opportunities for people, relatives and staff to give their views about the service. Processes were in place to manage and respond to complaints and concerns.
Incidents and accidents were investigated and actions were taken to prevent recurrence. The premises were well-maintained and clean.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 4 January 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.